Changing Sleep Medications: Hope, Uncertainty and Frustration

As someone who has tried several different sleep medications over the last few years, I'm still looking for my magic cure for insomnia. Switching sleep medications, or even increasing the dose of current medications, is, in my experience, a journey of hope, uncertainty, and oftentimes frustration.

Not only would I really love to sleep through the night, or at least part of it, but I know it would positively enable me to regain some control over my overall well-being. Unfortunately, trying new medications or doses for me has always been unpredictable. I've worked closely with my psychiatrist, continually examining the medications that provided any relief versus those that made no difference, how long to wait it out before changing dose or changing medications, and even how to temper the expectation of hope that this next change will be the one that makes everything better.

Why My Psychiatrist Oversees My Insomnia Treatment

Unlike a sleep specialist who might focus on behavioral modifications, sleep studies, or devices like CPAP machines, I work with my psychiatrist for my insomnia because my sleep issues are deeply intertwined with my mental health. My psychiatrist understands the broader context—how anxiety, stress, complex PTSD  and even past medication experiences contribute to my ongoing struggle with sleep. Having one provider who can see and understand the full picture of my emotional and psychological health has made me feel more confident in the adjustments we make to my treatment plan, especially as they've been numerous over the years.

The Transition: Moving from One Medication to Another

Right now, I am in the process of transitioning from Belsomra to Triazolam. I tried four different doses on Belsomra, and while it helped me to fall asleep quickly, nearly every night I'd be up from 1 or 2am until about 4:30 or 5 a.m. -- wide awake, productive awake, only sleeping for about 2 hours before this window and two hours after.

Although I gave it a long lasting chance to improve my sleep by keeping it a part of my routine for quite some time, I just finally had to admit that I needed more better nights than I was having. Given my history of poor response to other sleep aids like Ambien and Lunesta, my psychiatrist and I decided to try Triazolam, a medication that produces a calming effect on the brain and nerves, which helps you fall asleep and stay asleep.

It's been nearly a week, and I've already increased the dose once, but I still find myself waking up frequently throughout the night, sometimes feeling groggy yet still unable to sustain deep sleep. I just sent a message to my doctor's office asking to speak with him about this challenge. In order to make the most informed decisions, I need to know if the dose can be increased any further, how long I need to be on it to see a real difference, if I stop taking it will I need to taper off of it, will coming off of it cause side effects, and if this medication failed me - what other choices do I even have left?

The Emotional Toll of Medication Changes

As shared above, I am integrated into the decision-making process of changing medication or dosage, and although by now I feel like I maybe should know better, each change incidentally comes with a cautious optimism, wondering if this night would be different, if this medication change would finally work. The mental preparation for this experience has been much bigger than the physical one, and I imagine other community members may feel similarly.

There’s a certain emotional exhaustion that comes with chronic insomnia treatment. Each adjustment feels like another gamble —- another chance for something to work but also another opportunity for disappointment. I’ve learned to manage my expectations, but it’s hard not to hope that this time, sleep will come easily.

Major Takeaways from My Experience

1. Patience is essential. Medication changes take time, and finding the right sleep aid often requires trial and error. It’s frustrating but necessary to give each adjustment a fair chance.
2. Being an active participant in treatment matters. Working closely with my psychiatrist and openly discussing what is and isn’t working has helped me feel like I have some control over my treatment.
3. The emotional aspect of changing sleep medications is just as significant as the physical one. It’s important to acknowledge the hope, frustration, and mental energy that comes with every change.
4. Sleep medications are not a one-size-fits-all solution. What works for one person might not work for another, and even what worked before may stop working over time.
5. Non-medication approaches still play a role. While my primary treatment is medication-based, I’ve learned that supplementing it with good sleep hygiene, relaxation techniques, and stress management can make a difference.

Switching medications is never easy, and it rarely provides immediate results. But by working with my psychiatrist, staying informed, and managing my expectations, I continue to search for a solution that will finally bring me restful, restorative sleep.